[Sepsis in children using venous implants with reservoir]

Area of Science:

• Medical Microbiology
• Pediatric Oncology
• Vascular Surgery

Context:

• Chronic central venous access is crucial for pediatric patients requiring long-term therapies such as chemotherapy and total parenteral nutrition.
• Totally implanted venous access devices (port-a-cath systems) are commonly used but are associated with infectious complications.
• Catheter-related sepsis presents a significant risk in this vulnerable population.

Purpose:

• To investigate the incidence and management of catheter-related sepsis in pediatric patients with totally implanted venous access systems.
• To identify causative microorganisms and assess treatment outcomes, including the necessity of device removal.
• To evaluate the association between sepsis and complications such as thrombosis.

Summary:

• This study analyzed 25 implanted venous systems in 24 pediatric patients (3 months to 16 years) experiencing catheter-related sepsis.
• Infectious episodes included septicemia caused by Candida albicans, Staphylococcus aureus, and Staphylococcus epidermidis.
• Four systems required removal due to unsuccessful antimicrobial therapy; one patient developed superior vena cava and right atrial thrombosis requiring surgical intervention.

Impact:

• These findings underscore the critical need for timely diagnosis and management of catheter-related sepsis in pediatric patients with implanted venous devices.
• Device removal is frequently essential for successful sepsis eradication and preventing severe sequelae.
• The study highlights the potential for serious complications, emphasizing the importance of vigilant monitoring and prompt treatment decisions.